<%@ page contentType="text/html;charset=UTF-8" %>
<%@ include file="/WEB-INF/views/include/taglib.jsp" %>

<form:form id="inputForm" data-parsley-validate="" modelAttribute="turnInVo"
           onsubmit="return formLeaveHospLoad('turnOutForm','inputForm','${ctx}/nurse/wardCirculation/saveLeaveHospPatient','${ctx}/doctor/patVisit/index','${turnInVo.patientId}','${turnInVo.visitId}');"
           method="post" class="form-horizontal">
    <form:hidden path="id"/>
    <form:hidden path="patientId"/>
    <form:hidden path="patVisitId"/>
    <form:hidden path="bedRecId"/>
    <div class="form-group">
        <label class="col-sm-4 control-label">床号：</label>

        <div class="col-sm-8">
            <form:input path="bedNo" htmlEscape="false" class="form-control" maxlength="32" readonly="true"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">床标号：</label>

        <div class="col-sm-8">
            <form:input path="bedLabel" htmlEscape="false" class="form-control" maxlength="32" readonly="true"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">姓名：</label>

        <div class="col-sm-8">
            <form:input path="name" htmlEscape="false" class="form-control" maxlength="32" readonly="true"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">性别：</label>

        <div class="col-sm-8">
            <form:select path="sex" id="sex" class="form-control" data-parsley-required="true" disabled="true">
                <form:options items="${fns:getDictList('SEX_DICT')}" itemLabel="label" itemValue="value"
                              htmlEscape="false"/>
            </form:select>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">预交金：</label>

        <div class="col-sm-8">
            <input class="form-control" maxlength="20" readonly value="${turnInVo.prepayments}"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">出院科室：</label>

        <div class="col-sm-8">
            <input readonly class="form-control"  value="${fns:getDeptName(turnInVo.deptStayed,'' )}"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">出院病区：</label>

        <div class="col-sm-8">
            <input readonly class="form-control"  value="${fns:getDeptName(turnInVo.wardCode,'' )}"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">出院时间：</label>

        <div class="col-sm-8">
            <input class="form-control" maxlength="20" readonly
                   value="<fmt:formatDate value="${turnInVo.dischargeDate}" pattern="yyyy-MM-dd HH:mm:ss"></fmt:formatDate>"/>
        </div>
    </div>
    <div class="form-group">
        <label class="col-sm-4 control-label">出院方式：</label>

        <div class="col-sm-8">
            <form:select path="settledType" id="settledType" class="form-control" data-parsley-required="true" >
                <form:options items="${fns:getDictList('DISCHARGE_DISPOSITION_DICT')}" itemLabel="label"
                              itemValue="value" htmlEscape="false"/>
            </form:select>
        </div>
    </div>
    </div>
    <div class="form-group">
        <div class="col-sm-offset-2 col-sm-10">
            <input id="btnSubmit" class="btn btn-primary" type="submit" value="确 定">&nbsp;
          <%--  <input id="btnCancel" class="btn" type="button" value="关 闭" onclick="closeLeaveHospForm()"></div>--%>
    </div>
</form:form>
